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Enhanced recovery after abdominal wall reconstruction: a systematic review and meta-analysis

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Abstract

Background

Enhanced recovery after surgery (ERAS) are evidence-based protocols associated with improved patient outcomes. The use of ERAS pathways is well documented in various surgical specialties. The aim of this systematic review and meta-analysis was to examine the efficacy of ERAS protocols in patients undergoing abdominal wall reconstruction (AWR).

Methods

This systematic review and meta-analysis were reported according to PRISMA and MOOSE guidelines. The databases PubMed, EMBASE, CINAHL, Web of Science and Cochrane Library were searched for original studies comparing ERAS with standard care in patients undergoing AWR. The primary outcome was length of stay (LOS) and secondary outcomes were readmission and surgical site infection (SSI) and/or surgical site occurrences (SSO).

Results

Five studies were included in the meta-analysis. All were retrospective cohort studies including 453 patients treated according to ERAS protocols, and 494 patients treated according to standard care. The meta-analysis demonstrated that patients undergoing AWR managed with ERAS had a mean 0.89 days reduction in LOS compared with patients treated with standard care (95% CI − 1.70 to − 0.07 days, p = 0.03). There was no statistically significant difference in readmission rate (OR 1.00, 95% CI 0.53 to 1.87, p = 1.00) or SSI/SSO (OR 1.19, 95% CI 0.67 to 2.11, p = 0.56) between groups.

Conclusions

The use of ERAS in patients undergoing AWR was found to significantly reduce LOS without increasing the readmission rate or SSI/SSO. Based on the existing literature, ERAS protocols should be implemented for patients undergoing AWR.

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Funding

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Authors and Affiliations

  1. Department of Surgery, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark

    Lise Lode & Nadia A. Henriksen

  2. Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark

    Erling Oma & Kristian K. Jensen

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  1. Lise Lode
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  2. Erling Oma
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  4. Kristian K. Jensen
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Correspondence to Lise Lode.

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Lise Lode, Erling Oma, Nadia A. Henriksen and Kristian K. Jensen have no conflicts of interest or financial ties to disclose.

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Lode, L., Oma, E., Henriksen, N.A. et al. Enhanced recovery after abdominal wall reconstruction: a systematic review and meta-analysis. Surg Endosc 35, 514–523 (2021). https://doi.org/10.1007/s00464-020-07995-6

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  • DOI: https://doi.org/10.1007/s00464-020-07995-6

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